Provider Demographics
NPI:1821090895
Name:CARR, VINCENT FRANCIS (DO)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:FRANCIS
Last Name:CARR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2704 LARGO PL
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-2343
Mailing Address - Country:US
Mailing Address - Phone:301-805-7294
Mailing Address - Fax:
Practice Address - Street 1:42 AMANDAS TEAL DR
Practice Address - Street 2:
Practice Address - City:BRIDGEVILLE
Practice Address - State:DE
Practice Address - Zip Code:19933-2406
Practice Address - Country:US
Practice Address - Phone:301-807-8613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-10
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS-003303-L207R00000X, 207RC0000X
NY182107207R00000X, 207RC0000X
MDH0058104207RC0000X
DEC2-0010188207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine